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WALGREEN EASTERN CO., INC
CH021790 HUDSON HEADWATERS HEALTH NETWORK
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Covered Entity Details
Entity Name
HUDSON HEADWATERS HEALTH NETWORK
Subdivision Name
Hudson Headwaters Administrative Offices
Type
HRSA-Funded Health Center
340B ID
CH021790
Entity Address
9 CAREY ROAD
QUEENSBURY, NY 12804
Grant Number
H80CS00159
Participating Start Date
4/1/2001
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC
Pharmacy Address
WALGREENS # 17227
173 CHURCH ST.
SARANAC LAKE, NY 12983-1843
Pharmacy Comments
Contract Details
Approval Date
4/1/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/29/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
James T Donnelly, EVP of 340B Pharmacy Services
(518) 824-2340
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/1/2020
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